Perm Medical Journal最新文献

{"title":"Non-alcoholic fatty liver disease and pregnancy","authors":"T. P. Shevlyukovа, I. A. Bulatovа","doi":"10.17816/pmj41377-85","DOIUrl":"https://doi.org/10.17816/pmj41377-85","url":null,"abstract":"The issues of epidemiology, risk factors, and pathogenetic mechanisms of non-alcoholic fatty liver disease during pregnancy are considered in the review. The impact of liver steatosis and obesity on the course and outcome of pregnancy, the perinatal state of the mother and fetus are described. Fluctuations in the hormonal spectrum, an increase in body weight, which can affect the development and progression of liver steatosis, occur during pregnancy. Women of reproductive age with metabolic syndrome, obesity require a thorough examination and, if it is necessary, optimization of metabolic health before planning pregnancy. Pregnant women with liver pathology need dynamic control and prevention of disease progression and associated obstetric complications.","PeriodicalId":507221,"journal":{"name":"Perm Medical Journal","volume":" October","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141823607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical case of heterotopic pregnancy after in vitro fertilization","authors":"V. Y. Naumova, M. V. Semenova, A. R. Mukhametgalimova","doi":"10.17816/pmj413136-142","DOIUrl":"https://doi.org/10.17816/pmj413136-142","url":null,"abstract":"Ectopic pregnancy occupies a significant place in the structure of causes of maternal mortality. Timely diagnosis is even more complicated when there is a combination of both uterine and ectopic localization of the ovum. The article describes the clinical observation of heterotopic pregnancy, features of the clinical picture, diagnostic search and treatment strategy. The possibility of preservation of intrauterine pregnancy after surgical removal of a pathologically located second fertilized ovum has been shown. The patient was admitted to the gynecological department with complaints of bleeding from the genital tract against the background of delayed menstruation. An ultrasound examination revealed the presence of dichorionic diamniotic twins, with one fertilized egg localized in the interstitial part of the fallopian tube stump. Surgical removal of the stump with the fertilized egg was performed. The intrauterine pregnancy was preserved. Thus, with timely diagnosis of heterotopic pregnancy and adequate tactics, it is possible to maintain intrauterine pregnancy.","PeriodicalId":507221,"journal":{"name":"Perm Medical Journal","volume":"119 36","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141822262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of main risk factors and cytokine profile in patients with acute coronary syndrome and different serum myostatin levels","authors":"A. R. Akhmadzyanova, Y. Khovaeva, D. Sosnin, A. V. Sobolev, E. I. Voronova","doi":"10.17816/pmj41342-50","DOIUrl":"https://doi.org/10.17816/pmj41342-50","url":null,"abstract":"Objective. To study the prevalence of the main risk factors and the value of proinflammatory cytokines in patients with acute coronary syndrome (ACS) depending on the determined level of serum myostatin. \u0000Materials and methods. 120 patients with ST elevation ACS (STE-ACS) and non-ST-segment elevation ACS (NSTE-ACS), hospitalized in the cardiology department of the regional vascular center were examined. In 86 patients, the level of serum myostatin and proinflammatory cytokines was determined on the 5th day of the development of acute coronary syndrome. \u0000Results. Patients were divided into two subgroups depending on the level of serum myostatin which was determined: group 1 – with a lower level of myostatin, group 2 – with a higher level of myostatin. Group 1 (serum myostatin level from 0.038 to 0.084 ng/ml) consisted of 23 patients (16 males). Group 2 (serum myostatin level from 0.137 to 0.630 ng/ml) contained 21 patients (14 males). The main risk factors for cardiovascular diseases such as family history of early development of cardiovascular diseases, smoking, dyslipidemia, obesity, arterial hypertension and type 2 diabetes mellitus were assessed. \u0000The levels of pro-inflammatory cytokines were determined. Tumor necrosis factor alpha (TNF-alpha) and interleukin 18 (IL-18) levels were significantly higher in patients with higher myostatin levels. Correlation analysis revealed a relationship between serum myostatin concentration and TNF-alpha level (r = 0.34; p = 0.0016). \u0000Conclusions. No differences in the prevalence of risk factors in patients with ACS and different myostatin levels, except for smoking were revealed in the study, the frequency of smoking was higher in the group with higher myostatin levels. Greater activity of pro-inflammatory cytokines TNF-alpha and IL-18 was revealed in patients with higher levels of myostatin, as well as a significant correlation between the level of myostatin and TNF-alpha.","PeriodicalId":507221,"journal":{"name":"Perm Medical Journal","volume":" 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141822857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of intestinal microbiota parameters in young people with metabolic syndrome","authors":"T. S. Dushina, S. Klyashev, L. A. Suplotova, E. Dorodneva, M. V. Nikolenko","doi":"10.17816/pmj4135-14","DOIUrl":"https://doi.org/10.17816/pmj4135-14","url":null,"abstract":"Objective. To study the features of the colon microbiota, as well as the associations of microbial representatives with anthropometric, anamnestic and biochemical parameters in young patients with metabolic syndrome. \u0000Materials and methods. 118 young people took part in a single-center, one stage, controlled study. 87 of them were diagnosed with obesity, and 31 people with normal body weight formed the control group (“C”). 87 obese patients were divided into 2 groups: “MS-” which consisted of 43 people (49.4%), and “MS+” including 44 people (50.6%) with metabolic syndrome. When stratifying the groups, the NCEP ATP III criteria were used. Blood for biochemical test was taken from all the participants, and the condition of the colon microbiota was assessed using polymerase chain reaction («Colonoflor-16 (premium)»). The Microsoft Excel 2010 and IBM SPSS Statistics 26.0 application software package were used for statistical calculations. The results were evaluated as statistically significant at a level of p0.05. \u0000Results. In the MS+ group Fusobacterium nucleatum (Fusobacteriaceae family) was detected statistically significantly more often than in individuals from group “C” (40.5%). Differences in the bacterial composition of the intestinal microbiota between two groups of obese people were revealed: in the “MS+” group there was a significant decrease in bacteria of the genus Bifidobacterium (Bifidobacteriaceae family), Prevotella (Prevotellaceae family) and Faecalibacterium prausnitzii (Ruminococcaceae family) (p0.05). In addition, correlation patterns between the species and generic composition of the microbiota on the one hand and age, BMI, waist circumference, hip circumference, breastfeeding duration, indicators of carbohydrate (glucose, insulin, HOMA-IR index) and lipid (total cholesterol, triglycerides, low-density lipoproteins, very low-density lipoproteins, high-density lipoproteins) metabolism, CRP on the other hand have been established. \u0000Conclusions. The colon microbiota in obese patients is characterized by proinflammatory changes. For the metabolically unhealthy phenotype of obesity these changes are most characteristic. It is clear that further research is needed to determine the mechanisms underlying the influence of bacterial-fungal associations on metabolism in obese individuals, as these mechanisms are likely to play a key role in the development of metabolic diseases.","PeriodicalId":507221,"journal":{"name":"Perm Medical Journal","volume":" 966","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141823285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical case of stage combined treatment of a patient with infected pancreonecrosis and its early and late complications","authors":"V. Samartsev, A. A. Domrachev, V. Gavrilov, D. Sosnin, R. A. Stepanov, A. Parshakov, A. S. Kobeleva","doi":"10.17816/pmj413143-152","DOIUrl":"https://doi.org/10.17816/pmj413143-152","url":null,"abstract":"Acute pancreatitis is the 3rd most common abdominal pathology after acute appendicitis and acute cholecystitis occurring in 10 to 25% of patients. The lethality in acute pancreatitis, according to different data, varies from 15 to 25%. We presented the results of minimally invasive stage combined endovideosurgical and X-ray vascular treatment of the patient with infected subtotal mixed pancreonecrosis complicated by pseudocyst formation of pancreatic tail, recurrent arrosive hemorrhage, formation of external gastric and incomplete external pancreatic fistula in the late postoperative period.","PeriodicalId":507221,"journal":{"name":"Perm Medical Journal","volume":"117 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141821256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic fatty liver disease as a risk factor for early renal dysfunction in women of reproductive age","authors":"P. E. Erbes, S. Shulkina, E. N. Smirnova","doi":"10.17816/pmj41333-41","DOIUrl":"https://doi.org/10.17816/pmj41333-41","url":null,"abstract":"Objective. To study the correlation of adipocytokines with early renal dysfunction indicators in women of reproductive age with obesity and metabolic fatty liver disease. \u0000Materials and methods. The study included 100 obese females divided into 2 groups. The 1st group consisted of patients (n=50) diagnosed with metabolic fatty liver disease aged 40,5±2,8, and the 2nd group contained patients (n=50) without metabolic fatty liver disease (MFLD). The level of insulin, cystatin C, resistin, leptin, monocyte chemoattractant protein (MCP-1), vascular endothelial growth factor (VEGF), interleukin 6 (IL 6), tumor necrosis factor α (TNF) were determined in blood serum by enzyme-linked immunosorbent assay (ELISA) method. Albumin-to-creatinine ratio, TNF- α, MCP-1, IL 6, cystatin C, b2-microglobulin, VEGF were determined in morning urine. \u0000Results. Increased levels of pro-inflammatory cytokines and endothelial dysfunction were revealed in group 1 in relation to both the comparison and control groups. In patients with MFLD associations of resistin level were the following: with HOMA(r=0,60), alanine aminotransferase (ALT) (r=0,54), aspartate aminotransferase (r=0,71), gamma-glutamyl transpeptidase (r=0,71), high-density lipoprotein (HDL) (r=‒0,54), VEGF (r=0,54), TNF- α (r=0,44), MCP-1 (r=0,57) р0,05. In the 1st and 2nd groups cytokine urinary excretion and renal dysfunction markers were higher than in the control group. Associations of urinary excretion of b2-mic­ro­globulin with BMI (r=0,33), НОМА (r=0,34), resistin (r=0,30), uric acid level (r=0,50), creatinine (r=0,34), thyroglobulin (r=0,31), urinary MCP-1(r=0,60), IL 6 (r=0,70) р0,05 were revealed in the 1st group. In group 1 associations of urinary IL 6 with BMI (r=0,35), waist/hip circumference (WC/HC) (r=0,33), uric acid level (r=0,44), urinary MCP-1(r=0,74) were positive, and associations with HDL (r=‒0,44) р0,05. \u0000Conclusions. Resistin can be considered as an unfavourable marker of cardiometabolic disturbances in patients with MFLD. The association of subclinical inflammation markers and endothelial dysfunction with the markers of early renal impairment in patients with MFLD which was determined allows to expand the understanding of cardio-renal-metabolic continuum.","PeriodicalId":507221,"journal":{"name":"Perm Medical Journal","volume":"117 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141822003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of long-term dynamics of antibiotic sensitivity of coagulase-negative staphylococci isolated from surgical hospital patients at various times","authors":"E. V. Afanasievskaya, A. Kasatov, N. V. Nikolaeva, S. V. Pospelova","doi":"10.17816/pmj4125-10","DOIUrl":"https://doi.org/10.17816/pmj4125-10","url":null,"abstract":"Objective. To carry out twenty-year analysis of dynamics of antibiotic sensitivity of coagulase-negative staphylococcal strains isolated from surgical hospital patients. \u0000Materials and methods. The antibiotic sensitivity of 191 strains of coagulase-negative staphylococci isolated in 2004, 2014, 2023 year from surgical hospital patients was studied with the disk diffusion method. \u0000Results. A significant increase in the proportion of strains resistant to all antibiotics known, especially ciprofloxacin, was found. \u0000Сonclusion. A twenty-year analysis of the dynamics of antibiotic sensitivity showed a significant increase of antibiotic resistance of coagulase-negative staphylococcus strains isolated from surgical patients.","PeriodicalId":507221,"journal":{"name":"Perm Medical Journal","volume":"17 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141104669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Migration of Hem-o-Lok clips into the bladder after radical prostatectomy – own experience","authors":"O. Bogomolov, T. V. Sukhanova, M. I. Shkolnik, A. Kneev, A. L. Dolbov, М. V. Artemov","doi":"10.17816/pmj412130-135","DOIUrl":"https://doi.org/10.17816/pmj412130-135","url":null,"abstract":"Non-absorbable polymer Hem-o-Lok clips are widely used during nerve-sparing radical prostatectomy for clipping of the neurovascular bundle, as well as for rapid knotless fixation of sutures during the formation of urethrovesical anastomosis. At the same time, cases of migration of Hem-o-Lok clips into the bladder at various times after RP have been described. \u0000Our retrospective analysis of 1321 patients, who underwent laparoscopic radical prostatectomy at A.M. Granov Russian Scientific Center of Radiology and Surgical Technologies from 2014 to 2023, revealed 3 cases of Hem-o-Lok clip intravesical migration. Also, to search for similar cases of this rare complication a literature review was conducted. \u0000The frequency of postoperative intra-bladder clip migration in our study was 0.23 % (3/1321). One case of spontaneous clip passage was observed 3 months later the radical prostatectomy. In two other cases, long-term symptoms of dysuria (in 7 months and 4 years, respectively) revealed clip incrustation, which led to the removal of the clips through endoscopic intervention and laser cystolithotripsy. \u0000Despite the low incidence of this complication, the use of Hem-o-Lok clips during laparoscopic radical prostatectomy, should be minimized reasonably, particularly during the urethro-vesical anastomosis formation. If lower urinary tract symptoms and/or hematuria occur at any point in the postoperative period, it’s advisable to conduct an instrumental examination of the bladder to rule out potential clip migration and possible incrustation.","PeriodicalId":507221,"journal":{"name":"Perm Medical Journal","volume":"36 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141103892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rehabilitation potential in patients with prostate cancer: psychological aspect","authors":"I. V. Ponomareva, A. I. Kuznetsova, A. V. Vazhenin, D. A. Tsiring, Ya. N. Pakhomova, M. N. Mironchenko","doi":"10.17816/pmj41219-32","DOIUrl":"https://doi.org/10.17816/pmj41219-32","url":null,"abstract":"Objective. To determine a list of psychological characteristics associated with the prognosis of prostate cancer outcome and rehabilitation potential in patients with cancer. \u0000Materials and methods. The study of psychological characteristics (subjective and personal characteristics of study participants (n = 148)) associated with rehabilitation potential was carried out using the following psychological methods: Methodology of Subjective Control Level (E.F. Bazhin, E.A. Golynkina, L.M. Etkind), Questionnaire of ways to cope (adapted by T.L. Kryukova, E.V. Kuftyak, M.S. Zamyshlyaeva), Questionnaire SF-36 “Assessment of the quality of life”, Test of vitality (adapted by D.A. Leontiev, E.I. Rasskazova), Basic Beliefs Scale (adapted by M.A. Padun, A.V. Kotelnikova). \u0000Results. A favorable prognosis for the outcome of prostate cancer is associated with the patient`s involvement in the events of his life and active participation in them, understanding of the significance of the problem, partial independence from others, slight limitation of role functioning due to the emotional state, optimal social functioning in combination with beliefs about the benevolence of the world around him and ability to control events. \u0000Conclusions. A list of psychological characteristics associated with the course of the disease in patients with prostate cancer was obtained. These psychological characteristics can define the rehabilitation potential, being associated with the possibilities of recovery after antitumor treatment.","PeriodicalId":507221,"journal":{"name":"Perm Medical Journal","volume":"9 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141106830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The options for prognosis of the outcome of ischemic stroke in young patients","authors":"V. V. Gusev, O. А. Lvova, O. P. Kovtun, N. А. Shamalov, A. P. Sergeev, M. V. Sergeeva, D. A. Medvedeva","doi":"10.17816/pmj41287-95","DOIUrl":"https://doi.org/10.17816/pmj41287-95","url":null,"abstract":"Objective. To develop criteria for prognosis of the outcome of ischemic stroke, taking into account age, dynamics of state assessment, the Rankin and NIHSS scales readings and the fact of disability in the long-term period. The universal reliable criteria, that allow to predict the outcome of ischemic stroke, have not been developed yet. \u0000Material and methods. The study group consisted of 246 patients with ischemic stroke aged 18 to 44 who were observed from 2008 to 2021. \u0000Results. It is impossible to predict disability in a long-term period of ischemic stroke reliably. Predicting the outcome of ischemic stroke using the Rankin and NIHSS scales is significant in the acute period and allows to predict the dynamics of recovery in mild and moderate cases. \u0000Conclusion. The predictive value of the integrative indicators of the patient's condition, assessed by the Rankin and NIHSS scales, has been established.","PeriodicalId":507221,"journal":{"name":"Perm Medical Journal","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141107608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}